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Journal of Healthcare Engineering
Volume 3 (2012), Issue 3, Pages 373-390
Research Article

Learning from Aviation to Improve Safety in the Operating Room - a Systematic Literature Review

Linda S. G. L. Wauben,1,2,3 Johan F. Lange,2 and Richard H. M. Goossens3,4

1Department of BioMechanical Engineering, Faculty of Mechanical, Maritime and Materials Engineering, Delft University of Technology, Delft, The Netherlands
2Faculty of Industrial Design Engineering, Delft University of Technology, Delft, The Netherlands
3Department of Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands
4Department of Neuroscience, Erasmus University Medical Center, Rotterdam, The Netherlands

Received 1 December 2011; Accepted 1 March 2012

Copyright © 2012 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Lessons learned from other high-risk industries could improve patient safety in the operating room (OR). This review describes similarities and differences between high-risk industries and describes current methods and solutions within a system approach to reduce errors in the OR. PubMed and Scopus databases were systematically searched for relevant articles written in the English language published between 2000 and 2011. In total, 25 articles were included, all within the medical domain focusing on the comparison between surgery and aviation. In order to improve safety in the OR, multiple interventions have to be implemented. Additionally, the healthcare organization has to become a ‘learning organization’ and the OR team has to become a team with shared responsibilities and flat hierarchies. Interpersonal and technical skills can be trained by means of simulation and can be supported by implementing team briefings, debriefings and cross-checks. However, further development and research is needed to prove if these solutions are useful, practical, and actually increase safety.